Provision of Health Promotion Information by Physiotherapists to In-Patients in a Tertiary Hospital: A Pilot Study

A Peer Reviewed Publication of the College of Allied Health & Nursing at Nova Southeastern University Dedicated to allied health professional practice and education http://ijahsp.nova.edu Vol. 7 No. 3 ISSN 1540-580X Provision of Health Promotion Information by Physiotherapists to In-Patients in a Tertiary Hospital: A Pilot Study Chris J. MacFarlane, B Physiotherapy1 Kathy Stiller, PhD, B App Sc (Physio)2 1. 2. Clinical Educator, Physiotherapy Department, Royal Adelaide Hospital Principal Physiotherapist, Research Coordinator, Physiotherapy Department, Royal Adelaide Hospital Australia CITATION: MacFarlane, C. Stiller, K. Provision of health promotion information by physiotherapists to in-patients in a tertiary hospital: a pilot study. The Internet Journal of Allied Health Sciences and Practice. July 2009, Volume 7 Number 3. ABSTRACT Purpose: The provision of health promotion information is an important part of the management of hospitalised patients. Allied health practitioners are often involved in the provision of this information. No studies appear to have documented the rate of provision of health promotion material by physiotherapists to hospitalised patients. The aim of this pilot study was to measure the frequency with which health promotion information was provided to in-patients by physiotherapists and to evaluate patients’ perception of the effectiveness of this information. Method: Retrospective medical record audits and follow-up telephone interviews were undertaken over an 18 month period for patients who fell into one of the following four diagnostic groups: total hip arthroplasty (THA), after upper limb lymph node biopsy/removal and therefore at risk of upper limb lymphoedema, chronic obstructive pulmonary disease (COPD) or accidental fall requiring admission to hospital. Results: 63 patients participated in the medical record audits and 50 participated in the telephone interviews. The medical record audits revealed that 64% of patients were provided with some health promotion information during their hospitalisation. From the telephone interviews, 88% of patients indicated that they were happy with the information they had received. However, the rate of provision of health promotion material was significantly lower for patients with COPD or those admitted after a fall. Conclusions: While the overall level of provision of health promotion material by physiotherapists was satisfactory, provision of this material to COPD patients and those admitted after a fall needs to become part of physiotherapists’ standard clinical practice. INTRODUCTION The World Health Organization Ottawa Charter for Health Promotion identifies the need for a reorientation of health services to focus on the promotion of health rather than management of disease, and also reinforces the need to increase awareness of the use of health promotion in hospitals.1,2 Hospitals are well placed to promote health in view of the central role they play in providing health services within the community.2 In the 2006-2007 financial year, the total health expenditure by the Australian Government was $94 billion, an estimated rise of $7.3 billion since the previous financial year, and representing 9% of gross domestic product.3 Over one-third of this expenditure was attributed to hospital services, whereas only 5% was spent on community and public health programs.3 The increasing health expenditure and high proportion of it attributed to hospitals highlights the need for them to play a central role in health promotion. The use of health promotion to aid in the prevention of disease has been widely documented and shown to be effective for problems such as smoking, obesity, falls prevention, and chronic obstructive pulmonary disease (COPD) management. 4-9 However, few studies have evaluated the frequency or effectiveness of the provision of health promotion information to hospital in-patients.10,11 Given the nature and range of patients with whom they interact, physiotherapists are one of the healthcare © The Internet Journal of Allied Health Sciences and Practice, 2009 Provision of Health Promotion Information by Physiotherapists to In-Patients in a Tertiary Hospital: A Pilot Study 2 professionals who have the opportunity to provide health promotion information to in-patients. A literature search of Medline and CINAHL databases was unable to identify any studies which specifically investigated the frequency and effectiveness of the provision of health promotion information to in-patients by physiotherapists. Thus, the aim of this pilot study was to measure the frequency with which health promotion information was provided to in-patients by physiotherapists and to evaluate patients’ perception of the effectiveness of this information. METHOD Design Retrospective medical record audits and follow-up via telephone interviews were conducted at an inner city tertiary hospital, Royal Adelaide Hospital (RAH). Ethical approval was obtained from the RAH Research Ethics Committee. Participants Inclusion criteria Four diagnostic groups were selected for potential inclusion into the study because literature reviews revealed that there was evidence supporting the effectiveness of health promotion in their management and physiotherapy commonly formed part of their in-patient management.12-16 These diagnostic groups comprised patients: · after total hip arthroplasty (THA) · following upper limb lymph node biopsy/removal and therefore at risk of upper limb lymphoedema · with COPD · admitted to hospital following an accidental fall. The names of potential participants were obtained by screening the RAH medical record database for those with a diagnostic code that fell into one of the four eligible groups and who had been seen by a physiotherapist during their period of hospitalisation. Initially this was limited to a six month period from January to June 2007. Each medical record identified was given a sequential number and a sample of medical records was randomly selected from this list and further screened for eligibility. In the event that this time period did not yield a sufficient sample size, the time period was able to be extended. Exclusion criteria Patients were excluded from participation if their medical record revealed that their treatment was palliative in nature or they had suffered a major post-operative complication (eg pulmonary embolus, THA implant failure), as it was deemed that the more severe nature of their condition may have affected their hospital management and thus the provision of health promotion information. Patients unable to understand English were excluded because of an inability to organise translation services for the study due to time and resource constraints. Patients with cognitive impairment (eg severe dementia, dense cerebrovascular accident, mental illness) were excluded as these patients might have difficulty recalling information regarding their hospital management duri (...truncated)